Impact Of Poor Housing On Children: Leadership In Public Health Homework Answer

Answer :

Introduction

Housing is considered as a determinant of health and comfort for human beings. Sub-standard housing is a significant issue in public health that leads to individuals' psychological, social, and physical problems. Even child health is associated with biological, chemical and physical, aspects of the home such as accessibility, cleanliness, noise, pests, injury risks, moisture, and environmental quality. Poor housing conditions contribute a broad category of health issues that influence the children's development (Krieger and Higgins, 2002; Weitzman et al., 2013). Thus, inadequate housing is associated with children's well-being, behaviour problems, and educational attainment (Clair, 2018; Pevalin et al., 2017). 

Public health has been involved in housing issues, and thus, dealing with housing issues is an opportunity for public health practitioners to deal with an essential social health determinant. Initially, health officials usually target crowding, poor sanitation, poor ventilation, and fire hazards but today, public health departments may follow multiple strategies like formulating and implementing housing guidelines and codes, and making Healthy Homes programs to improve house indoor environmental quality, assessment of housing conditions, and support for affordable and healthy housing (Krieger and Higgins, 2002). The housing health and safety rating system (HHSRS) was introduced in 2004 in the UK for risk-based evaluation by local authorities to identify and manage housing-related potential risks and hazards to health and safety (GOV.UK, 2006).

Discussion 

Background of Case study

This case represents an environmental health practitioner's leadership quality who got a referral from a social worker and inspected the house (privately rented) where five children (5-13 years old) live with their mother. The reviewed place is a pre-1920 built three-storey property and poorly converted into the family home from individual bedsits. The formal notice of entry was issued, and inspection was carried out according to guidelines of HHSRS. During the inspection, the house was found to lack necessary facilities like a heating system, hot water, unsafe electrical accessories, falling plasterboards from the ceiling, lack of fire detection, and lack of gas safety certificates. Including this, the house was filthy and identified as a category one hazard. Environmental Health Practitioner used all the legislative powers from formal action to prosecution and as per enforcement procedure of the Council. 

Environmental Health Practitioner worked in harmonization with other departments like environment health management, pollution department, social services, fire service, child protection service, etc. A core team was made to improve the house's condition and ensure the safety of children. The overall remedial action led to installing the smoke alarm, repair of front door lock, gas safety check, repair of electric accessories, removal of dog, the order of large bins for rubbish, cleaning in external areas, etc. Environmental Health practitioners' hard work resulted in the living of children in category one hazard free home, improvement in health, improvement in school attendance, and improvement in children's school reports. Children were able to play with friends, feel safe at home, and study in their rooms. The landlord was also prosecuted, and he paid £7k to the local authority.

Key Elements of the Organizational Sphere of Public Health 

The organizational sphere of public health represents the involvement of different departments and agencies to maintain general health. The Public health department in the UK is responsible for keeping people healthy by promoting a healthy lifestyle, protecting from public health hazards, identifying public health challenges, sharing information, and responding to public health emergencies (Public Health England, 2021). UK public health network comprises 18 different organizations, which included nine membership organizations and nine statutory organizations where statutory organizations play the role of observer. The partner organizations are distributed in many groups such as organizations, networks/alliances/coalitions, agencies, etc. Each member performs its role in public health by interacting with other national and international organizations (Lodge, 2016). At the individual level, Public Health UK comprises researchers, scientists, and public health professionals (Public Health England, 2021). 

The selected case study demonstrates the critical elements of the organizational sphere of public health as the network of different departments/agencies (Environmental Health Management, child protection service, Social Housing Department, fire service, judiciary, and pollution department, etc.) and individuals (Environmental Health Practitioner, social workers, fire brigade, nurses, police, and probation officers, etc.) worked in a coordinated way to achieve the goal of improvement of living conditions of five children. 

 The principles of governance of the organizational sphere of public health are reflected in this case. The Environmental Health Practitioner received the referral from a social worker, and then formal notice for entry was served to initiate the inspection. Including this, all activities such as informal meeting with the landlord, prosecution, and remedial action to repair the property and rehousing children were performed in an organized way. 

Recognition of the Range of Relevant Leadership Styles

Public health incorporates health care, clinical care, and public health concept to improve the health of individuals. Public health is a diverse and interdisciplinary field where leaders and professionals from different backgrounds work towards the development of the community (Public Health Leadership, 2018).). Leaders make an inspiring vision, set direction, and make the team achieve the goal. Leadership comprises field-related knowledge, skill, attitude, management, and some essential traits like vision associated hard work and role model assets (Srivastava and Kunwar, 2018). Including this, leaders demonstrate extensive life experience and possess the quality to focus their teams, free from disputes and conflicts, and constructive approaches (Cismas et al., 2016). Despite sector-specific properties, leaders have some shared values or styles, such as; has a vision, innovative, risks-bearing nature, determined, and brave (Gianfredi et al., 2019; Grigsby, 2019).  Public health leaders significantly play an essential role in managing the population's well-being and health through health promotion, implementing healthcare policies, establishing network and collaboration, and efficient decision-making process (Gianfredi et al., 2019).  Though public health leaders are different from other sectors concerning the nature of work, goal, target audience, policies, and challenges, but like all other leaders, they possess essential attributes of public health leadership such as vision, influence, values, and competencies, Educators and Learners, etc. Including this, public health leaders also have the competency to create and maintain relationships with other organizations. The different healthcare leadership styles are charismatic, transformational, transactional, and servant (Regis College, 2021) and out of these Environmental Health Practitioner represented a transformational leadership style.

The selected study demonstrated the Environmental Health Practitioner's leadership qualities in a transformational style that how he managed to improve the housing conditions of five children (strong vision). According to the case, he got a social worker's referral to inspect the property where five children were living with their mother. He inspects the property and makes efforts to improve the housing conditions of children (self-management). He demonstrates all the mentioned leadership qualities. He makes efforts to improve the housing conditions of children, and it reflects his vision. He inspects the property by formal notice of entry and prepares a prosecution report, reflecting the quality of courage, knowledge, and skill. He regularly visits the property and social housing department many times, this activity reflects the quality of efforts and hard work. He interacts with different departments for different jobs, reflecting his quality of coordination, partnership working, and relationships with other organizations (building relationships and cognitive competence). Moreover, he comprises social workers, teachers, doctors, nurses, probation officers, fire brigade, and police. These activities reflect the qualities of influence, communication, and team management to achieve the goal (collective organizational consciousness). 

Understanding the Challenges of Partnership Working 

The partnerships are becoming essential to deliver public services in an efficient and organized manner (Lamie and Ball, 2010). Partnerships offer the working of many departments to achieve a similar objective in a fast and well-organized manner. The multiagency partnerships express many attributes such as coexistence, cooperation, coordination, collaboration, and co-ownership (Rodrigo, 2016). The partnerships often reduce the cost of implementation and increase the efficiency and possibilities of success of a vision. Successful partnerships are assumed to share many properties such as aims and goals, awareness about activities, responsibilities associated with each partner, planned strategy, continuous monitoring, and evaluation to ensure the plan's success. The quality of services delivered through the health and social sector involves many professionals and departments working together to fulfil common aims; thus, effective partnerships play an important role (Rodrigo, 2016). Though multiagency partnership offers the high possibility of efficient implementation of health and social care services, there are many challenges of these partnerships that affect the outcome, such as lack of transfer of information from between departments, lack of understanding of roles between the departments, poor inter-agency collaboration, lack of coordination, competing interests and funding (Rodrigo, 2016; Taylor-Robinson et al., 2012; Welstead, 2013).

This case study represented the challenges of partnership working. At the time of the incident, many agencies like Child Protection Services, Social Housing Department, Fire Services, Environmental Health Management, Neighbourhood Wardens and Pollution Department, etc., were present. However, still, children were living in the filthy property that was severely affecting their education, social life, and health. This case reflects the lack of dissemination of information between different departments, lack of coordination, and resource limitations. To improve the housing conditions, Environmental Health Practitioner made several visits to the property to gas safety checks and performance of other work. Limitation of resources is also an essential factor that affects the partnership between different departments as Environmental Health Management was requested to waive off the fee to remove the dog from the property. 

This case made an important contribution to the improvement of alliances between different partners, the transfer of information between departments, and how one agency deals with the problem. This case also improved the presence of partners in the meetings because all the partners knew the outcome of their efforts as children would get a warm and safe home (Taylor-Robinson et al., 2012; Welstead, 2013). 

Recognition of the Importance of Change Management/Leadership Processes 

The partnership's desired outcome is influenced by many factors such as; communication, resources, strong leadership and management, clarity about roles and responsibilities, team building, information sharing, managing organizational differences, hierarchical relationships, etc. (Rodrigo, 2016). In health care and social services, all the partners share common traits such as common goals, similar ethos, belief, mutual trust, and understanding the contribution of each partner, etc. (Sheehy, 2017). Thus, it is evident that proper coordination is necessary between different departments to establish well functional relationships between participating partners. 

Change management is recognized as a structured approach to transition from the present state to the desired functional state to achieve the desired goal in an organization. A good leader is recognized for many attributes like communication, clarity, transparency, and accountability. Thus, change management/leadership requires playing an important role in communication and commitment to achieve the goal (Deshler, 2020).

This selected case study represents the requirement of change management/leadership to attain the goal of re-housing of five children that is free from category one hazards and fulfils the Decent Home Standards. However, this process consumed a long duration of about eight months, during which children must not be in a comfortable situation. Thus, the case demonstrated that senior management faced many difficult challenges in child protection services when there was a lapse in standards because Environmental Health practitioners often visited the property. Though his visits were to check the progress of work done by other departments, this represented the challenges in management to deal with the issue. Including this, many visits to the Social Housing department to make them aware of the housing requirement of the children represents a lack of coordination between different departments, and thus there was an urgent requirement to change the management/leadership process. 

This case reflected the partnership and multiagency cooperation requirement to address the issue like child welfare, poor housing, and reduced resources, which resulted in improvement in alliances, transfer of information, and trust-building between different departments. The overall changes were due to the Environmental Health Practitioner's efforts in a positive way so that children obtained a good quality, warm and safe home. 

In this study, the lack of coordination was observed between different departments; thus, change management must focus on transferring information, deciding roles and responsibilities, and team building, etc. For this purpose, the departments' digitalization is a good approach to transfer the information in a fast and efficient way. The properties that may be inspected frequently are rated according to HHSRS. Due to the increased use of the internet, different portals may be created for better implementation of policies related to public health. Including this, the focus may be done for scientific training, character building, and systematic evaluations of professionals' skills.

Conclusion

It is observed that many families in England are living in poor-quality homes due to unstable economic conditions, high rent, and un-affordability of good quality homes. Moreover, many sub-standard houses are recognized as category one hazards by HHSRS. House conditions, lack of basic amenities are found associated with health, education, and behaviour of the children, which affect the well-being of children, educational attainment, health, and social life. In 2013, in England, 3.6 million children were residing in bad quality homes (Darlington, 2016). This study demonstrated the exceptional leadership qualities of Environmental Health practitioners, the role of partnerships and related challenges. These challenges should be addressed for more effective implementation of public health policies in England.